Funeral Wishes Form
Full Name:
Date of Birth:
Address:
Postcode:
Telephone:
Signed:
Date:
Full Name of Next of Kin:
Relationship:
Next of Kin Address:
Next of Kin Postcode:
Next of Kin Telephone:
Type of Funeral Service:
Music to be played:
Readings or poetry to be read:
Other requests:
I would like an order of service to be printed: YesNo
Type of coffin: VeneerSolidWickerCardboard
Cremated or Buried: CrematedBuried
Separate funeral service to take place at:
Cremation to take place at:
After cremation, I would like: Scattered at the Crematorium in the Garden of RemembranceInterred at a Cemetery / ChurchyardCollected by family
Burial location:
Preferred Minister or Officiant:
I do/do not wish to be viewed in the Chapel of Rest: YesNo
Dressing preference: In my own clothesIn a funeral gown
Last journey by: Traditional funeral hearseHorse-drawn hearseOther
Journey to start from: The Funeral Directors premisesMy homeOther
Floral tributes from: Anyone who wishes to send themFamily onlyNone
Donations to:
Announcement to be placed in a Newspaper: YesNo
Name of Newspaper:
Account to be settled by: My estateMy familyAn insurance policyA Pre-Paid Funeral Plan
Pre-Paid Funeral Plan Provider:
Policy Number:
Your email:
Please complete this form if you would like to record your own funeral wishes. This document can then act as a guide to your family and friends, to let them know what kind of funeral you would like. You can give as much detail as you want, with the headings below given as a guide as to the kind of information you might like to include. Please feel free to add extra pages if necessary, with any additional details you wish to be known.
If possible, please tell someone that you have completed this form and keep a copy of it in a safe place. We can also keep a copy of it or, if you have made a Will, you may wish to keep a copy of this form with it.
enquiries@jamesashton.co.uk